Clinical Application of Sentinel Node Biopsy in T1 or less Breast Cancers Is it Effective or Feasible? / 한국유방암학회지

ABSTRACT

BACKGROUND: Sentinel node biopsy has emerged recently as an alternative to routine axillary node dissection in predicting the axillary nodal metastasis and various studies habe shown its effectiveness in patients with breast cancer. However there have been some controversies in clinical application because of high false negative rate. MATERIALS AND METHODS: One hundred and forty patients with breast cancer underwent operative management in consideration of the results of patients with breast cancer underwent operative management in consideration of the results of sentinel node biopsy at department of surgery in Samsung Medical Cancer between Sep. 1995 and July 1998. Sixty-three patients with tumor size of T1 or less were retrospectively evaluated. Intra-operative lymphatic mapping using vital blue dye was performed in 53 patients and using combination of vital dye and 99mTc-antimony sulphide colloid in 10 patients. RESULTS: patients ages were in the third decade in 1 patients (3.2%), in the forth decade in 18 (28.6%), in the fifth decade 18 (28.6%), in the sixth decade in 13 (20.6%) and in the seventh decade in 12 (19.0%). The patients had infiltrating ductal carcinoma in 51 patients(81.0%), intraductal carcinoma in 8 (12.6%), medullary carcinoma in 2 (3.2%), infiltrating lobular carcinoma in 1 (1.6%) and mucinous carcinoma in 1 (1.6%). Sentinel node was detected in 42 of 53 patients (79.2%) evaluated with vital blue dye only and 10 of 10 (100%) evaluated with combination of vital dye and 99mTc-antimony sulphide colloid. Among the group of T1 of less, each sensitivity rates of vital dye and combination were 81.8% and 100% and accuracy of them were 95.2% and 100% respectively. Each false negative were 12.2% and 8.3% in total cases but they were decreased to 6.1% and even 0% in the group of T1 or less. CONCLUSION: The detection rate and accuracy of sentinel node biopsy were enhanced in patients with T1 or less breast cancer. If the combination of vital dye and radioisotope is used, sentinel node biopsy may be applied clinically in limited patients such as T1 or less breast cancer.